Holiday Tips for Alzheimer’s Caregivers

By Sondra Forsyth

Many caregivers of loved ones with Alzheimer’s disease have mixed feelings about holidays. Caregivers may have happy memories of the past but they also may worry about the extra demands that holidays make on their time and energy.

Here, from the National Institute on Aging, are some suggestions to help you find a balance between doing many holiday-related things and resting:

• Celebrate holidays that are important to you. Include the person with AD as much as possible.
• Understand that things will be different. Be realistic about what you can do.
• Ask friends and family to visit. Limit the number of visitors at any one time. Plan visits when the person usually is at his or her best (see the section below about “Visitors”).
• Avoid crowds, changes in routine, and strange places that may make the person with AD feel confused or nervous.
• Do your best to enjoy yourself. Find time for the holiday activities you like to do. Ask a friend or family member to spend time with the person while you’re out.
• Make sure there is a space where the person can rest when he or she goes to larger gatherings such as weddings or family reunions.

Visitors

Visitors are important to people with AD. They may not always remember who visitors are, but they often enjoy the company.

Here are ideas to share with a person planning to visit someone with AD:

• Plan the visit when the person with AD is at his or her best.
• Consider bringing along some kind of activity, such as a well-known book or photo album to look at. This can help if the person is bored or confused and needs to be distracted. But, be prepared to skip the activity if it is not needed.
• Be calm and quiet. Don’t use a loud voice or talk to the person as if he or she were a child.
• Respect the person’s personal space, and don’t get too close.
• Make eye contact and call the person by name to get his or her attention.
• Remind the person who you are if he or she doesn’t seem to know you.
• Don’t argue if the person is confused. Respond to the feelings that they express. Try to distract the person by talking about something different.
• Remember not to take it personally if the person doesn’t recognize you, is unkind, or gets angry. He or she is acting out of confusion.

Don’t expect too much:

• A person with AD may have trouble deciding what to do each day. This could make your loved one fearful and worried or quiet and withdrawn.
• A person with AD may have trouble starting tasks. Remember, the person is not being lazy. He or she might need help organizing the day or doing an activity.

Daily activities

Plan activities that the person with AD enjoys. He or she can be a part of the activity or just watch. Also, you don’t always have to be the “activities director.” For information on adult day care services that might help you, see Adult day care services.

Here are things you can do to help the person enjoy an activity:

• Match the activity with what the person with AD can do.
• Choose activities that can be fun for everyone.
• Help the person get started.
• Decide if he or she can do the activity alone or needs help.
• Watch to see if the person gets frustrated.
• Make sure he or she feels successful and has fun.
• Let him or her watch if that is more enjoyable.

The person with AD can do different activities each day. This keeps the day interesting and fun. The information below may give you some ideas.

Household chores

Doing household chores can boost the person’s self-esteem. When the person helps you, don’t forget to say “thank you.”

The person could:

• Wash dishes, set the table, or prepare food.
• Sweep the floor.
• Polish shoes.
• Sort mail and clip coupons.
• Sort socks and fold laundry.
• Sort recycling materials or other things.

Cooking and baking

Cooking and baking can bring the person with AD a lot of joy.

He or she might help do the following:

• Decide on what is needed to prepare the dish.
• Make the dish.
• Measure, mix, and pour.
• Tell someone else how to prepare a recipe.
• Taste the food.
• Watch others prepare food.

Children

Being around children also can be fun. It gives the person with AD someone to talk with and may bring back happy memories. It also can help the person realize how much he or she still can love others and can still be loved.

Here are some things the person might enjoy doing with children:

• Play a simple board game.
• Read stories or books.
• Visit family members who have small children.
• Walk in the park or around schoolyards.
• Go to sports or school events that involve young people.
• Talk about fond memories from childhood.

Music and dancing

Music can bring back happy memories and feelings. Some people feel the rhythm and may want to dance. Others enjoy listening to or talking about their favorite music. Even if the person with AD has trouble finding the right words to speak, he or she still may be able to sing songs from the past.

Consider the following musical activities:

• Play CDs, tapes, or records.
• Talk about the music and the singer.
• Ask what he or she was doing when the song was popular.
• Talk about the music and past events.
• Sing or dance to well-known songs.
• Play musical games like “Name That Tune.”
• Attend a concert or musical program.

Pets

Many people with AD enjoy pets, such as dogs, cats, or birds. Pets may help “bring them to life.” Pets also can help people feel more loved and less worried.

Suggested activities with pets include:

• Care for, feed, or groom the pet.
• Walk the pet.
• Sit and hold the pet.

Going out

Early in the disease, people with AD may still enjoy the same kinds of outings they enjoyed in the past. Keep going on these outings as long as you are comfortable doing them.

Plan outings for the time of day when the person is at his or her best. Keep outings from becoming too long. You want to note how tired the person with AD gets after a certain amount of time (1/2 hour, 1 hour, 2 hours, etc.).

The person might enjoy outings to a:

• Favorite restaurant
• Zoo, park, or shopping mall
• Swimming pool (during a slow time of day at the pool)
• Museum, theater, or art exhibits for short trips

Remember that you can use a business-size card, as shown below, to tell others about the person’s disease. Sharing the information with store clerks or restaurant staff can make outings more comfortable for everyone.

Eating out

Going out to eat can be a welcome change. But, it also can have some challenges. Planning can help. You need to think about the layout of the restaurant, the menu, the noise level, waiting times, and the helpfulness of staff. Below are some tips for eating out with the person who has AD.

Before choosing a restaurant, ask yourself:

• Does the person with AD know the restaurant well?
• Is it quiet or noisy most of time?
• Are tables easy to get to? Do you need to wait before you can be seated?
• Is the service quick enough to keep the person from getting restless?
• Does the restroom meet the person’s needs?
• Are foods the person with AD likes on the menu?
• Is the staff understanding and helpful?

Before going to the restaurant, decide:

• If it is a good day to go.
• When is the best time to go. Going out earlier in the day may be best, so the person is not too tired. Service may be quicker, and there may be fewer people. If you decide to go later, try to get the person to take a nap first.
• What you will take with you. You may need to take utensils, a towel, wipes, or toilet items that the person already uses. If so, make sure this is OK with the restaurant.

At the restaurant:

• Tell the waiter/waitress about any special needs, such as extra spoons, bowls, or napkins.
• Ask for a table near the washroom and in a quiet area.
• Seat the person with his or her back to the busy areas.
• Help the person choose his or her meal, if needed. Suggest food you know the person likes. Read parts of the menu or show the person a picture of the food. Limit the number of choices.
• Ask the waiter/waitress to fill glasses half full or leave the drinks for you to serve.
• Order some finger food or snacks to hold the attention of the person with AD.
• Go with the person to the restroom. Go into the stall if the person needs help.

Traveling

Taking the person with AD on a trip is a challenge. Traveling can make the person more worried and confused. Planning can make travel easier for everyone. Below are some tips that you may find helpful.

Before you leave on the trip:

• Talk with your doctor about medicines to calm someone who gets upset while traveling.
• Find someone to help you at the airport or train station.
• Keep important documents with you in a safe place. These include: insurance cards, passports, doctor’s name and phone number, list of medicines, and a copy of medical records.
• Pack items the person enjoys looking at or holding for comfort.
• Travel with another family member or friend.
• Take an extra set of clothing in a carry-on bag.

After you arrive:

• Allow lots of time for each thing you want to do. Do not plan too many activities.
• Plan rest periods.
• Follow a routine like the one you use at home. For example, try to have the person eat, rest, and go to bed at the same time he or she does at home.
• Keep a well-lighted path to the toilet, and leave the bathroom light on all night.
• Be prepared to cut your visit short.

People with memory problems may wander around a place they don’t know well (see How to cope with wandering).

In case someone with AD gets lost:

• Make sure they wear or have something with them that tells who they are, such as an ID bracelet.
• Carry a recent photo of the person with you on the trip.

Spiritual activities

Like you, the person with AD may have spiritual needs. If so, you can help the person stay part of his or her faith community. This can help the person feel connected to others and remember pleasant times.

Here are some tips for helping a person with AD who has spiritual needs:

• Involve the person in spiritual activities that he or she has known well. These might include worship, religious or other readings, sacred music, prayer, and holiday rituals.
• Tell people in your faith community that the person has AD. Encourage them to talk with the person and show him or her that they still care.
• Play religious or other music that is important to the person. It may bring back old memories. Even if the person with AD has a problem finding the right words to speak, he or she still may be able to sing songs or hymns from the past.